It's really rare to actually catch a cardiac arrest on Camera. Even rarer for it to make it onto TV in the States. HIPAA killed a lot of the shows, like Life in the ER and Paramedics: Life on the Streets which showed what REALLY happens when a person does.

BronyMedic:WTFDYW: Nice find subster. Should be shown at CPR/AED classes.

[www.cardiauk.com image 629x259]

It's really rare to actually catch a cardiac arrest on Camera. Even rarer for it to make it onto TV in the States. HIPAA killed a lot of the shows, like Life in the ER and Paramedics: Life on the Streets which showed what REALLY happens when a person does.

Bob The Nob:Strange how his arms raised slowly by themselves right after they laid him down and began the chest compressions.

Paging Dr. Fark ...

It happens. Cardiac-induced Seizure and posturing caused by his brain not getting enough blood. If you look at the EKG, he doesn't actually have his heart stop - it goes into Ventricular Tachycardia. It's just beating "too fast" to pump out blood. They start CPR because he's got signs of poor perfusion and a questionable pulse.

If you notice to, when he does it, he also starts gasping. Those are agonal respirations, and are not effective breathing patterns. It's the reason they teach laypeople to do CPR when they see it.

Happens in station more than you might think. But in order to survive, this is exactly how quickly CPR and defibrillation needs to happen.I think it's funny because I give the same "Your EKG is a little odd" line when I see shiat I don't like.

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.

Bob The Nob:Strange how his arms raised slowly by themselves right after they laid him down and began the chest compressions.

Paging Dr. Fark ...

Judging by the rate, but not being able to see the EKG proper, he was most likely in vtach. He's unresponsive and pulseless and for all intents and purposes, he's dead (Jim).There is still a bit of contractility to the muscles, though he has no control. I'm trying to think of an analogy. I'm sure I'll think of one later.

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.

There was a medic who was transporting a patient around here who went into sudden cardiac arrest and died.I also had a patient who was having a massive cerebellar stroke, and the closest hospital that could deal with it (requires surgery) was about an hour and a half away, so of course we flew him out. Came to find out later they had just finished working one of their own they found deceased in his bunk at the station.

But again, everyone thinking they need to go out and buy an AED, it was the chest compressions that did the most good here. It was a witnessed arrest and he was in a rythm that could be interupted. An AED will not reverse asystole or restart your heart. There was a lot that was cut out of this, and my only complaint is that the editing made it look too easy.

Why yes, I expect to die in the back of an ambulance myself. I just hope I'm not transporting at the time.

Short answer: It interupts a chaotic electrical signal that causes the heart to beat ineffectively, potentially returning it to an effective rhythm. However if the rhythm preceding the chaotic rhythm was asystole (not beating), then that's what you get back.

cretinbob:But again, everyone thinking they need to go out and buy an AED, it was the chest compressions that did the most good here.

QFT. Study after study is showing that ACLS, in the field, for the most part, is...well, not useless per se. But razor-sharp BLS skills (CPR and non-hyperventilating O2 support) are going to have a much better outcome than IVs and drug regimens, etc.

Not every time someone drops will they have a shockable rhythm, so good CPR skills are a must.

Nice save boys. Nice CPR and conversion from the tachycardia. It's always nice to see a conversion like that, with a good ending. Too often even if you are right there with the autodefib, and cpr..they still don't make it. It's nice to see a win for a change.

/It analyzes the rhythm of the heart, and if it sees an arrhythmia, such as tachycardia, or some other arrhythmia, it will charge, and give the user a verbal command to push the button that "hopefully" converts the arrhythmia to a sinus rhythm. You don't (as is commonly believed) shock a person who is in a state where their heart is not beating at all. There is no rhythm to convert, and the AED won't allow you to shock a "flat line" patient. You do CPR on someone like that, and introduce various drugs to hopefully get it restarted to a sinus rhythm or at least a arrhythmia you can convert. The sad thing is..you have minutes to start CPR at least or there will be brain damage due to hypoxia.

after reading the intro i couldn't watch the video. it upset me just to read what happened. i don't know how emergency responders and health professionals do what they can do. i consider them hero angels and i thank God they live among us.

KrispyKritter:after reading the intro i couldn't watch the video. it upset me just to read what happened. i don't know how emergency responders and health professionals do what they can do. i consider them hero angels and i thank God they live among us.

It was pretty admirable how quickly they went to automatic when their suspicions arose. It must lead to some shiatty times, but I hope on most days, they go home feeling pretty awesome about what they do.

dramboxf:Also, those medics in the vid weren't using an AED. That was a medic-fired defib.

Yeah, camew back to say that. It does have an automatic mode.It's a Life-Pak 15 made by PhysioControl. They are damn good (I use LifePak 12s, piss on Zoll, don't even think about Phillips)They'll set you back, depending on options $25k-$35k. That's without all the cables and extra batteries too. To be fair I was looking at a state bid sheet, so they may be a bit more depending on the dealer.

It'll monitor pulse O2 sat, B/P, do 3 lead and 12 lead EKG. You can monitor CO2 and CO levels depending on the model. In addition to defibrillation and synchronized cardioversion (which is probably what they did to this guy, not defibrillate) you can perform transcutaneous pacing.They are worth every penny.

cretinbob:It'll monitor pulse O2 sat, B/P, do 3 lead and 12 lead EKG. You can monitor CO2 and CO levels depending on the model. In addition to defibrillation and synchronized cardioversion (which is probably what they did to this guy, not defibrillate) you can perform transcutaneous pacing.

I saw a lifepak 9 in use the other day at a referring I did a transport from, and was almost shocked. I haven't seen those since 2006 around Memphis.

Never cardiovert PEA. It's one sure way to ensure you never get them back. ACLS had to add in a section explaining this because people were cardioverting PEA and asystole.

You can cardiovert vtach with a pulse, the various forms of SVT if they're unstable or you're a nice enough person to give them some fentanyl and versed first, and atrial fibrillation/flutter. (In the field, you want to avoid doing the later until they've been loaded with heparin if they've been in it longer than 24 hours. Be kinda bad to cause them to have a PE or Stroke.) But these are synchronized shocks - they ensure they deliver the shocks before the absolute and relative refractory periods to keep from killing the patient.

Since he had no pulse in the video, they lit him up with 200 joules, then 360 when that didn't work.

dramboxf:Or some of the BLS stuff coming down the pike, like not boarding every single patient that might have even just heard of someone having a spinal jolt?

Fascinating stuff.

That's been coming down the line for years, and the EMS profession in the US has been fighting tooth and nail against it because they're afraid of getting the pants sued off them for that one, mythical missed occult spinal injury (You have a better chance of finding bigfoot alive). If we cared about spinal immobilization, we'd be using KEDs and vacuum mats with every patient who has neuro symptoms.

I helped teach a CFR class as recently as fall of 2011 and we were still All About The Long Board. I also hear a lot of medics whining about possibly losing ETI in favor or King or other advanced airways.

Fascinating Subby. UK first aider and as has been noted above, you can sing Nelly the Elephant to Resici-Annie until you're blue in the face but there's no substitute for at least footage of hands on experience

I've had 2 episodes where I simply could not get my breath (I'm 50)... drove myself to the hosp ER both times - whenever I'd cough (not while driving) I'd loose my vision for a second or so... turns out my electrical signal to the upper part of my heart had it beating at around 222 and a BP of 182/148 or so (kinda hard to read the machines behind you with wires and an IV sticking out of you. I was told I was dehydrated and given magnesium and some other stuff. Took in around 4 bags of saline but they kicked me loose after 6 (+/-) hrs the first time. Did the same thing the 2nd time (about 10 months later) but then called me back in 20 minutes later. Fortunately I live right between Forsyth Memorial & Baptist Bowman Grey and have interns/residents/RNs and assorted med professionals living all around me, so as long as I can make it to the front yard, I should be fine.

Back in 1998, I was living in Tucson, AZ. I was 33 years old. I was about 100lbs overweight. I fell asleep one night on my left side, fully dressed. Side note: My father died of a massive MI when he was 47.

I woke around 2:30am, feeling very hot and sweaty and dizzy with my left arm hurting. I felt a tightness, a pressure in my chest.

I had my roommate drive me to the ER since the hospital was only about 3 blocks away. Walked into a triage nurse yakking on the phone. She points to a chair. I shake my head. "Chest pain, left-arm pain, sweating." She directs me to a treatment room. They get me hooked up to the 12 lead, and as I'm shifting on the gurney to make myself more comfortable, I let out a belch that probably rattled the 3 floors above me. ER resident comes in, sees my EKG is a nice NSR (if a touch tachy, LOL) and correctly determines that my left arm hurts because I slept on it, my chest is tight because I have gas, and I'm sweaty because I fell asleep in Tucson fully dressed.

....thiiiiis close to getting discharged and she asks some personal history questions. "Both parents alive?"

"Dad's dead...47, MI."

"Welcome to an overnight stay in our telemetry unit."

FARK.

Stress test 3 days later revealed I have the heart of an Ox. My doctor now hates me. My bloods are great, my EKG is fantastic, and I'm still 75lbs overweight. (Losing quickly though...) My resting bp is usually 110/80 or so.

dramboxf:I also hear a lot of medics whining about possibly losing ETI in favor or King or other advanced airways.

Never happen in the US if the NREMT, NAEMSP and NAEMT have their ways. I COULD see it in urban areas where the average transport time is five minutes, but nowhere else. Especially not in the critical care transport or helicopter EMS environment.

The idea that Paramedics should not perform ETI is based on a group of research studies conducted by a doctor who had a demonstrated bias against Paramedics having intubation in their toolkit. JEMS did an article not too long ago on it where they deconstructed the study and pointed out the major issues it ignored - namely Paramedic oversaturation, and fewer avenues for them to practice a high risk, low volume skill.

dramboxf:I helped teach a CFR class as recently as fall of 2011 and we were still All About The Long Board

IIRC, the national standard curriculum update has it that selective immobilization and spinal rule-outs are only to be done by EMT-Basics and above. It's kinda the same reason that you're not taught to titrate oxygen as a CFR or Basic, and they tell you to give everyone a NRB at 15 liters.

The solution is to stop cranking out medics wholesale from unaccredited, often corporate affiliated programs that spring up overnight and give substandard education - teaching people to pass the Registry rather than teaching them to be Paramedics. Thankfully, as of 2014, you cannot get a Paramedic if you don't graduate from an accredited institution, and this is going to kill many of them.

Laws, yes. M-O-O-N spells "Firefighter/medics drop in station all the damn time." And on the fireground, too.

We've lost 5 or 6 firefighters/EMTs/Medics in station or on a fireground in the last 7 or 8 years. One guy was the last you'd ever think had heart issues. Ran marathons, didn't eat anything that cast a shadow, trim, about 5'8 and 140lbs, dropped on the golf course. 39 years old. Standing chatting with his guys (he was a Captain), his eyes rolled back and he went down like a sack of potatoes.

bump:I've had 2 episodes where I simply could not get my breath (I'm 50)... drove myself to the hosp ER both times - whenever I'd cough (not while driving) I'd loose my vision for a second or so... turns out my electrical signal to the upper part of my heart had it beating at around 222 and a BP of 182/148 or so (kinda hard to read the machines behind you with wires and an IV sticking out of you. I was told I was dehydrated and given magnesium and some other stuff. Took in around 4 bags of saline but they kicked me loose after 6 (+/-) hrs the first time. Did the same thing the 2nd time (about 10 months later) but then called me back in 20 minutes later. Fortunately I live right between Forsyth Memorial & Baptist Bowman Grey and have interns/residents/RNs and assorted med professionals living all around me, so as long as I can make it to the front yard, I should be fine.

Next time call 911. Don't drive yourself when you think you're having a heart attack. If you die while you are driving you can take innocent people with you. That is so selfish.